Feeling so deflated by this GP encounter (ADHD)

[nounderwire]

I have suspected for about a year and a half that I may have ADHD; in the last 6 months in particular I've become certain that I identify with many of the key traits. I have a history of anxiety and depression, and the more I read about late diagnoses of women in their 30s with this disorder, the more I'm convinced it's me.

I managed to get up the courage to book and attend a GP appointment to discuss it (I have booked 2 prior appointments and cancelled at the last minute), I just came back from my appointment. I ran through my symptoms which I'd written down so I'd remain clear, filled out the ADHD self-referral scale (which scored me as consistent with ADHD) and asked for a referral. My GP said "but what would you expect to get out of a referral?". I said - a diagnosis? Help? Medication? She huffed and puffed and said there wasn't much point in referring "because services are so stretched, you probably won't get anywhere, if at all". I said fine, how about if I speak to someone privately, can she recommend me or refer me to anyone? "I don't know anyone - you'd be better off Googling". I pushed her and she agreed to refer me anyway, as I'd rather be in the system, and I'm about to go on Mat leave and can't really afford a private diagnosis (though if I have to, will make it work).

Am I unreasonable to feel utterly deflated coming away from this appointment with a GP asking for help with my mental health with nothing but a recommendation to Google? I'm a pretty strong and resilient person but I came home and cried at how unimportant I was made to feel, it was awful.

If anyone does have any better recommendations of the steps I can proactively take towards diagnosis (rather than just 'Google it') that'd be most appreciated.

if you want an NHS referral there will be a local pathway, so ask again. First appointment will probably be in 12 - 18 months. If you want a private referral then it's reasonable for your GP not to know anyone, if they don't do many of those referrals.

I would ask to see another GP and be prepared to be pushy.

It's really awful for GPs to gatekeep anything at all on the basis of availability - it means no-one has the true picture of how badly the NHS is crumbling. I'd complain to the practice on that basis so she doesn't do it again.

GPs are humans and have ideological positions like others, that they should but don't always suppress. Sometimes it's their own overloadedness that causes this. We shouldn't just let it go though.

If GPs didn't gate-keep then the NHS would collapse in about a week....do you have any idea how much stuff we manage without referring?

If you're preventing access to treatment for people who meet the criteria for treatment and who would benefit from it, then I don't think you are doing the NHS any favours.

I'm not talking about filtering out those who wouldn't meet criteria or benefit.

Sorry she made you feel deflated. It's challenging to get a diagnosis for ADHD as an adult unless it severely affects your life and you usually have to 'prove' that you have had it since childhood, to the extent often you'll be asked to provide school reports etc that demonstrate these behaviours. Not saying this is right, but it probably would go nowhere. I don't actually think it's bad the GP wouldn't recommend someone private but they should have suggested a second opinion if you weren't satisfied or another route. You could see what the policy is in your local mental healthcare Trust but I wouldn't be optimistic. I was diagnosed at 14 and have it to the extent it affects my life quite badly, chances are I would be unlikely to be able to secure an assessment which is scary.

I got a diagnosis at 38 privately via Psychiatry-UK.com, it was easy (apart from all the forms about my difficulties and a view from someone who knew me as a child)and cost about £360. I had a virtual consult with a registered Psychiatrist. It happened reasonably quickly then but I think they are inundated now so might be a wait (but less than NHS pathway!).

I just paid so I don’t know much about it but I believe you can get referred via GP under the ‘right to chose’ thing and then get meds prescribed via NHS after titration completed. Try women with ADHD UK on FB for info on that and any questions. Also there is a neurodiversity board on MN too.

She shouldn't have gatekept. Not if you meet the criteria for assessment.

Long wait but worth it to know.

Assessment is long and incredibly detailed. Goes over absolutely everything from as early as your family can remember to.

Medication is a game changer for most of us who are struggling, and have a diagnosis.

They also like to discourage pursuing assessment and treatment because the medicine costs a bomb. But I wouldn't be here now if someone hadn't realised I had it.

Mental health services can’t even keep on top of all the people trying to kill themselves, those with schizophrenia and bipolar stopping their meds (because they’re nasty) and those with drug induced psychosis losing it and being brought in by police. You’ll be on a never ending waiting list unless you go privately, sorry.

I get how deflating and disappointing this experience would be - but I can see where the GP is coming from. There’s not a lot of help available of adults with ADHD, and the question what do you want out of a diagnosis’ is a worthwhile one to consider, I think. Sometimes it’s nice to know you’re not alone, sometimes you want to access therapeutic interventions etc - but you might be able to do that without a diagnosis. I have considered pursuing an ADHD diagnosis for myself but instead am trying to follow the route of CBT for the organisational challenges I can identify in myself. I work with a lot of kids with ADHD and we essentially support them to organise themselves with routines and good habits - a lot of them are on meds but personally I find that issue a bit fraught (although it’s a decision for individuals to make.) I don’t consider myself to be so affected by my potential ADHD that I want to take amphetamines to treat it but I know that some people
have a different experience to me so might want to take them.

I know a handful of adults with an ADHD diagnosis and there isn’t any nice, sexy solution to then making their lives easier for themselves. It’s a bit of a slog. For me, I consider it useful to think about the therapeutic ways I could help myself if I did have ADHD and do them anyway.

i think it’s worth bringing up anything that’s having a significant affect on your well being with a GP again though.

It used to be that patients presented to GPs with symptoms requiring professional opinion. Now they present with a diagnosis they've already settled on and demand for referral/treatment. Very odd times.

You can do self referral:

www.nhs.uk/service-search/mental-health/find-a-psychological-therapies-service/

OP, please research Right to Choose. You can be referred for a diagnosis this way, ask for Psychiatry UK. Currently 6 month wait to be seen.

psychiatry-uk.com/right-to-choose/

Also join this FB group; it's great and filled with advice and stories. facebook.com/groups/ukwomenwithadhd/

I have ADHD and I’m a therapist with clients who have ADHD. As bad as her response was, it’s predictable and in a way it is realistic. You’re not likely to get an assessment through the NHS. It is deflating. I would look to go down the private route if getting a diagnosis soon is important to you.

Google is the best way to find a local ADHD assessment. You would want to be face to face of possible. Find out the implications on a private diagnosis on you being able to get medication on prescription. If you’re TTC, pregnant and planning to breastfeed you can’t take the medication. You may find your symptoms harder to manage after having a child. This is totally normal. I would always recommend therapy for the management of symptoms and I would definitely recommend therapy if you do receive a diagnosis of ADHD. You will have spent years internalising the traits as something that was ‘wrong with you’ it can be very damaging to your self esteem. Society is very dismissive of ADHD so even with a diagnosis you will find yourself largely on your own with this. Having a therapist with an understanding of ADHD is very important.

I agree with @Black1985 but would add that a diagnosis alone - even without medication or if the meds don't work brilliantly for you - can be life-changing in liberating you from self-loathing. Many many women report a deep sense of shame being lifted. That's something that many GPs do not take into account when they ask 'what good would a diagnosis do?'.

Im a bit confused, you were referred in the end, is that what your OP says?

The problem with GPs is they are reluctant to refer you anywhere for anything, I have asked for a referral in the past for a neurologist and was fobbed off and now years on I need to pick this back up again as my symptoms are worse. I wont be fobbed off again

This is SO helpful - thank-you! I've seen private referral experiences in my research from £1.5k to £3k so was hesitant to go on the journey knowing it may take a big chunk of my mat leave savings, but this would be much more manageable!

I definitely won't consider any kind of medication to be a magic solution to what I've been going through, I think for me it's the acknowledgement and comfort of knowing some things in my life I have really disliked about myself and that I have seen as dysfunctional or 'wrong' would almost be justified. And moving forward knowing more about the condition would help me process, understand, and rationalise some behaviours. Thank-you!

Thank-you - this is absolutely the main reason why I'm seeking a diagnosis, to allow some liberation from the shame of wondering why I react to some things in some way, and just to have a bit of justification for the way I'm feeling.

I was referred, but she said there was such a wait there wasn't much point and I might not get anywhere, but I pushed as I'd rather be in the system. I totally understand how on its knees the NHS is and would not be even going to the GP unless I felt there was something wrong (it was my first GP appointment since 2019!), it's just such a shame we have to advocate so hard for our own health - I know I can make a fuss and go away and research the best options but so many other people can't.

You should seek a private diagnosis if the only reason is validation.

Psychiatry services are crumbling trying to stop people from killing themselves. It's just not an appropriate use of MH services I'm afraid.

I not quite sure why you are deflated then, you obtained the outcome you wanted which was a referral?

The visit was a success.

Really sorry you're suffering, it's such a stressful time. I had a fairly similar experience with my GP and was told to expect a 2 year wait for a first appointment when they did agree to refer me (which in itself took 6 months - much of that due to (ADHD induced) poor follow through on my part...!). At that point, I didn't feel that it was something I could wait that long for.

I ended up getting a private diagnoses through Psymplicity. If going private is financially viable, I wouldn't hesitate to do it again. It has been life changing for me and so validating. I had a 2 hour skype appointment a week after my first enquiry email and collected my first perscription a few days after. The diagnosis itself cost approx £1100 and I anticipate it will end up costing in the region of £2k total (for medication reviews and private prescriptions) before they transfer my care to my NHS GP (they do this once they are happy medication has settled). I looked at other private providers that are at a lower price point (e.g. Psychiatry UK mentioned upthread) but they all had a much longer waiting list. Once I'd committed myself to being seen privately, I wanted to be seen ASAP (I'm not very patient at the best of times - also ADHD induced!)

OP if you're able to go private, I've heard good things about them as well, https://www.mypaceuk.com you can get an appointment within a few weeks.

This is an excellent thread on Reddit about them, give detailed information on the whole process https://www.reddit.com/r/ADHD/comments/ts6c76/myexperienceewithgettinggaprivateeadhd/?utmsource=share&utmmmedium=iosapp&utmm_name=iossmf

Don't lost hope, I'm on a waiting list for an NHS assessment. I think experiences vary according to your area, sounds like you had an unfortunate experience. It's not true that it's hard to get diagnosed, many women in the fb group I mentioned have gotten it, and it's been life-changing.

Good luck.

I've just been diagnosed. Took me 18 months on the NHS from ringing my go. Awaiting meds appointment and titration.don't feel deflated, you got referred. And ignore people saying about mental health services. You have as much right as anyone else to access these services. Hopefully the sheer number of women our age getting diagnosed woll shift a huge change in diagnosis for girls in the future .